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Effects of tailored feedback on multiple health behaviors

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Annals of Behavioral Medicine

Abstract

Background: The effects of tailored intervention on multiple behaviors and possible moderators of tailoring effects have not yet been sufficiently demonstrated.Purpose: The purpose of this study was to examine the effectiveness of a computer-tailored intervention on smoking; physical activity; and fruit, vegetable, and fat intake; and to test potential moderators of the effectiveness (BMI, age, SES, gender, motivation, and the number of behaviors for which respondents met the recommendations from national guidelines).Methods: Respondents were randomly assigned to a tailored intervention group, receiving one tailored letter on all of these behaviors, or a control intervention group, receiving one general information letter on all behaviors.Results: Three months after the baseline assessment, the tailored intervention group showed significantly better effects than the control group for all behaviors studied, except for smoking. Notably, the intervention did not enhance the health behaviors, but rather reduced a decline in these behaviors during the 3-month study interval. Effect sizes were small. No moderating factors were found, except for the number of behaviors for which recommendations were met in the tailoring intervention group on fruit consumption. The largest effects of the tailored intervention were found for fruit in respondents who did not meet the recommendations for any behavior (Cohen’s d=0.3).Conclusions: A tailored intervention on multiple behaviors had significant, but limited effects when compared to generic information. The number of bad habits influenced the effects of the tailored intervention on fruit consumption.

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References

  1. RIVM:Gezondheid op Koers? Volksgezondheid Toekomst Verkenning 2002 (Health on Course? Explore the Future of Public Health 2002). Houten: Bohn Stafleu van Loghum, 2002.

    Google Scholar 

  2. World Health Organization:Diet, Nutrition and the Prevention of Chronic Diseases, WHO Technical Report Series. Geneva: World Health Organization, 2003.

    Google Scholar 

  3. De Vries H, Brug J: Computer-tailored interventions motivating people to adopt health promoting behaviours: Introduction to a new approach.Patient Education and Counseling. 1999,36:99–105.

    Article  PubMed  Google Scholar 

  4. Skinner C, Campbell M, Rimer B, Curry S, Prochaska J: How effective is tailored print communication.Annals of Behavioral Medicine. 1999,21:290–298.

    Article  PubMed  CAS  Google Scholar 

  5. Kreuter M, Farrell D, Olevitch L, Brennan L:Tailoring Health Messages: Customizing Communication With Computer Technology. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2000.

    Google Scholar 

  6. Bock B, Marcus B, Rossi J, Redding C: Motivational readiness for change: Diet, exercise and smoking.American Journal of Health Behavior. 1998,22:248–258.

    Google Scholar 

  7. Emmons K, Marcus B, Linnan L, Rossi J, Abrams D: Mechanisms in multiple risk factor interventions: Smoking, physical activity, and dietary fat intake among manufacturing workers.Preventive Medicine. 1994,23:481–489.

    Article  PubMed  CAS  Google Scholar 

  8. Gillman M, Pinto BM, Tennstedt S, et al.: Relationships of physical activity with dietary behaviors among adults.Preventive Medicine. 2001,32:295–301.

    Article  PubMed  CAS  Google Scholar 

  9. Jakicic J, Wing R, Winters-Hart C: Relationship of physical activity to eating behaviors and weight loss in women.Medicine and Science in Sports and Exercise. 2002,34:1653–1659.

    Article  PubMed  CAS  Google Scholar 

  10. King T, Marcus B, Pinto B, Emmons K, Abrams D: Cognitive-behavioral mediators of changing multiple behaviors: Smoking and a sedentary lifestyle.Preventive Medicine. 1996,25:684–691.

    Article  PubMed  CAS  Google Scholar 

  11. Kremers S, De Bruijn G, Schaalma H, Brug J: Clustering of energy balance-related behaviours and their intrapersonal determinants.Psychology and Health. 2004,19:595–606.

    Article  Google Scholar 

  12. Calfas KJ, Sallis JF, Zabinski M, et al.: Preliminary evaluation of a multicomponent program for nutrition and physical activity change in primary care: PACE + for adults.Preventive Medicine. 2002,34:153–161.

    Article  PubMed  Google Scholar 

  13. Campbell MK, Tessaro I, DeVellis B, et al.: Effects of a tailored health promotion program for female blue-collar workers: Health works for women.Preventive Medicine. 2002,34:313–323.

    Article  PubMed  Google Scholar 

  14. Jacobs A, Ammerman A, Ennett A, et al.: Effects of a tailored follow-up intervention on health behaviors, beliefs, and attitudes.Journal of Women’s Health. 2004,13:557–568.

    Article  PubMed  Google Scholar 

  15. Vandelanotte C, De Bourdeaudhuij I, Sallis JF, Spittaels H, Brug J: Efficacy of sequential or simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake.Annals of Behavioral Medicine. 2005,29:138–146.

    Article  PubMed  Google Scholar 

  16. Strecher V, Wang C, Derry H, Wildenhaus K, Johnson C: Tailored interventions for multiple risk behaviors.Health Education Research. 2002,17:619–626.

    Article  PubMed  Google Scholar 

  17. Brug J, Van Assema P: Differences in use and impact of computer-tailored dietary fat-feedback according to stage of change and education.Appetite. 2000,34:285–293.

    Article  PubMed  CAS  Google Scholar 

  18. Hulshof K, Lowik M, Kok F, et al.: Diet and other lifestyle factors in high and low socio-economic groups (Dutch Nutrition Surveillance System).European Journal of Clinical Nutrition. 1991,45:441–450.

    PubMed  CAS  Google Scholar 

  19. Hulshof K, Brussaard J, Kruizinga A, Telman K, Lowik M: Socio-economic status, dietary intake and 10 y trends: The Dutch National Food Consumption Survey.European Journal of Clinical Nutrition. 2003,57:128–137.

    Article  PubMed  CAS  Google Scholar 

  20. Lantz P, House J, Lepkowski J, et al.: Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of US adults.The Journal of the American Medical Association. 1998,279:1703–1708.

    Article  CAS  Google Scholar 

  21. Smith A, Smith C: Dietary intake and lifestyle patterns: Correlates with socioeconomic, demographic and environmental factors.Journal of Human Nutrition and Dietetics. 1994,7:283–294.

    Article  Google Scholar 

  22. Baker AH, Wardle J: Sex differences in fruit and vegetable intake in older adults.Appetite. 2003,40:269–275.

    Article  PubMed  Google Scholar 

  23. Vilhjalmsson R, Kristjansdottir G: Gender differences in physical activity in older children and adolescents: The central role of organized sport.Social Science and Medicine. 2003,56:363–374.

    Article  PubMed  Google Scholar 

  24. Ooijendijk W, Hildebrandt V, Stiggelbout M (eds):Trendrapport Bewegen en Gezondheid 2000/2001 (Tendency Report Physical Activity and Health 2000/2001). Plantijn Casparie Heerhugowaard: Heerhugowaard, 2002.

    Google Scholar 

  25. Slovinec D’Angelo M, Reid R, Brown K, Pipe A: Gender differences in predictors for long-term smoking cessation following physician advice and nicotine replacement therapy.Canadian Journal of Public Health. 2001,92:418–422.

    Google Scholar 

  26. Wetter D, Kenford S, Smith S, et al.: Gender differences in smoking cessation.Journal of Consulting and Clinical Psychology. 1999,67:555–562.

    Article  PubMed  CAS  Google Scholar 

  27. Osler M, Prescott E, Godtfredsen N, Hein H, Schnohr P: Gender and determinants of smoking cessation: A longitudinal study.Preventive Medicine. 1999,29:27–62.

    Google Scholar 

  28. Voedingscentrum:Zo eet Nederland 1998 (How the Dutch Eat 1998). Den Haag: Voedingscentrum, 1998.

    Google Scholar 

  29. Flegal K, Carroll M, Kuczmarski R, Johnson C: Overweight and obesity in the United States: Prevalence and trends, 1960–1994.International Journal of Obesity. 1998,22:39–47.

    Article  PubMed  CAS  Google Scholar 

  30. Hill JO, Wyatt H, Melanson E: Genetic and environmental contributions to obesity.Medical Clinics of North America. 2000,84:333–345.

    Article  PubMed  CAS  Google Scholar 

  31. Akbartabartoori M, Lean M, Hankey C: Relationship between cigarette smoking, body size and body shape.International Journal of Obesity. 2005,29:236–243.

    Article  PubMed  CAS  Google Scholar 

  32. Sharpe P, Granner M, Hutto B, Ainsworth BE, Cook A: Association of body mass index to meeting physical activity recommendations.American Journal of Health Behavior. 2004,28:522–530.

    PubMed  Google Scholar 

  33. De Vries H, Mesters I, Van der Steeg H, Honing C: The general public’s information needs and perceptions regarding hereditary cancer: An application of the integrated change model.Patient Education and Counseling. 2005,56:154–160.

    Article  PubMed  Google Scholar 

  34. De Vries H, Lezwijn J, Hol M, Honing C: Skin cancer prevention: Behaviour and motives of Dutch adolescents.European Journal of Cancer Prevention. 2005,14:39–50.

    Article  PubMed  Google Scholar 

  35. De Vries H, Mudde A, Leijs I, et al.: The European Smoking Prevention Framework Approach (ESFA): An example of integral prevention.Health Education Research. 2003,18:611–626.

    Article  PubMed  Google Scholar 

  36. Van Assema P, Brug J, Ronda G, Steenhuis I: The relative validity of a short Dutch questionnaire as a means to categorize adults and adolescents to total and saturated fat intake.Journal of Human Nutrition and Dietetics. 2001,14:377–390.

    Article  PubMed  Google Scholar 

  37. Van Assema P, Brug J, Ronda G, Steenhuis I, Oenema A: A short Dutch questionnaire to measure fruit and vegetable intake: Relative validity among adults and adolescents.Nutrition and Health. 2002,16:85–106.

    PubMed  Google Scholar 

  38. Wendel-Vos G, Schuit A, Saris W, Kromhout D: Reproducibility and relative validity of the short questionnaire to assess health enhancing physical activity.Journal of Clinical Epidemiology. 2003,56:1163–1169.

    Article  PubMed  Google Scholar 

  39. Wendel-Vos W, Schuit J:SQUASH. Short QUestionnaire to ASses Health enhancing physical activity. Centrum voor Chronische ziekten Epidemiologie Rijksinstituut voor Volksgezondheid en Milieu: Bilthoven, 2002, 1–55.

    Google Scholar 

  40. Brug J, Glanz K, Van Assema P, Kok G, Van Breukelen PJP: The impact of computer-tailored feedback and iterative feedback on fat, fruit and vegetable intake.Health Education and Behavior. 1998,25:517–531.

    Article  PubMed  CAS  Google Scholar 

  41. Dijkstra A, De Vries H, Roijackers J: Long-term effectiveness of computer-generated tailored feedback in smoking cessation.Health Education Research. 1998,13:207–214.

    Article  PubMed  CAS  Google Scholar 

  42. Oenema A, Tan F, Brug J: Short-term efficacy of a web-based computer-tailored intervention, main effects and mediators.Annals of Behavioral Medicine. 2005,29:54–63.

    Article  PubMed  Google Scholar 

  43. Cohen J:Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Earlbaum Associates, Inc., 1988.

    Google Scholar 

  44. Centraal Bureau voor de statistiek (CBS):Onderwijsniveau Beroepsbevolking (Level of Education of the Working Population). 2005, Statline. Retrieved April 20, 2005 from http://statline.cbs.nl/StatWeb.

  45. Green L, Lewis F:Measurement and Evaluation in Health Education and Health Promotion. Palo Alto, CA: Mayfield, 1986.

    Google Scholar 

  46. Kroeze W, Werkman A, Brug J: A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors.Annals of Behavioral Medicine (in press).

  47. Dijkstra A, De Vries H, Roijackers J, Van Breukelen G: Tailoring information to enhance quitting in smokers with low motivation to quit: Three basic efficacy questions.Health Psychology. 1998,17:513–519.

    Article  PubMed  CAS  Google Scholar 

  48. Kremers S, Visscher T, Seidell J, Van Mechelen W, Brug J: Cognitive determinants of energy balance-related behaviours: Measurement issues.Sports Medicine. 2005,35:923–933.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to T. Smeets M.P.H..

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Smeets, T., Kremers, S.P.J., de Vries, H. et al. Effects of tailored feedback on multiple health behaviors. ann. behav. med. 33, 117–123 (2007). https://doi.org/10.1007/BF02879892

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